MAD (oral appliance) with C/APAP?

[REMmi]

1/16/25 hello, I made my 1st visit to my usual dentist for complemtary visit. As, I had heard good things about Oral Appliances, I think they are called Mandibular Advanced Devices. And have a 2nd visit scheduled where he will "make his suggestions" .

However, on a OSA podcast, from Oct, 2020 Episode 9 of Emma Cooksey with Dentist Dr. David Madow , he used a device, pre CPAP, and has concerns about what the Oral devices might do to the jaw, and teeth.

So, my thinking that maybe I could use an oral device and instead of a FFMask, use maybe nasal pillow with it.

Do people ever use both at the same time?


Any thoughts whether I should pursue the device any further? As doesn't seem to be covered by insurance, any further visits will cost out of pocket.

[DaveSkvn]

I had a MAD made about 10 years ago. It wasn't for me. Obviously to do its job it has to hold the jaw forward. Something has to take the force of the jaw trying to move back and that is the teeth. I have a couple of missing front teeth since childhood so there was a lot of stress on those that remained and they were not happy by morning. Normally your jaw will naturally drift around at night. With a MAD it will be clamped in place. I understand the benefit is proportional to how far your jaw can move forward. My jaw doesn't move forward much so there weren't many gains to be had. In the UK a private (out of pocket) MAD from a hospital orthodontist cost equivalent of $700 ten years ago. I don't regret giving it a try but you have to weigh up the costs where you are.

[SleepImprovement]

MAD didn’t seem to do much for me (and caused some pains). Tried it in conjoint with CPAP but without improvement.

[Old Steve]

You will still need the CPAP as the MAD only works on mild cases.  I would just use the CPAP with a full face mask or a nasal mask and tape my mouth.  If you are concerned about mouth breathing I doubt that the MAD device would help much with that.  

[REMmi]

ok thanks for the replies, I've just heard it put forth as a viable alternative, by many . like a lot of cpap information, it can be difficutl to make a decision what is worth trying. My next possible , is to see if there is some kind of ENT procedure to clear nasal passages, last night I could breath through my nose, until the CPAP pressure was on, then I could not for some reason. So, used a decongestant , then I could, but thats not viable to use more than 3 days, tonight I may just try saline spray, and nasal strips, as I heard that breathing through the nose creates Nitrous Oxide or something, meanwhile I use a neck collar now, but am unclear if it helps, and also kind of trying to get into a fixed routine. Probably don't want to tape the mouth, if I can't breath through my nose on pressure?

[Ndugu]

I'm trying to fix my nasal congestion as well. Interested in what you find.

I tend to drool into my mask as my nose gets congested while asleep.

[REMmi]

I'm trying to fix my nasal congestion as well.  Interested in what you find.

I tend to drool into my mask as my nose gets congested while asleep.

my PCP suggested taking flonase , said it can be used over months, on day 3 now night 2 so far,  despite being a mouth breather I may try a nose pillow or mask, and a chinstrap/mouth tape, I bought that Myotape from Ireland , its in the mail, folks say that the direct nasal pressure may clear the passages,

I can't figure out why when I 1st put on the F20 FFM , lay flat I can't nose breath, maybe its the pressure starting, as later on in the night, I can nose breath, though despite the soft collar I think I mouth breath most of the night judging by the Oscar expire morphology.

with both air touch and fit I'm noticing the mask starts to leak at the end of the nights like a burping, though the touch is better, last night I was thinking it was due to some drool in the mask, I also max'd out the climate hose for humidity and temperature though,

tonight I'm keeping a 2nd air touch F20 , bedside to swap out and see it /the foam not being damp helps, as in the past I just gave up on the night when couldn't get the cheek burping to stop and remove the mask, after too many awakenings, not going to be able to sleep anyway.......

[REMmi]

well the extra F20 didn't help, but I did have rainout and totally soaked memory foam, and earlier relatively unstable large airleaks, may try a hybrid tonight, asked MD re: aerophagia and a CPAP pressure, just putting me back on 6-11 ONSS titration and EPR1, maybe it will be better on the trazadones, but previously was getting pressure tabletop at 14 so he raised it to 8-15, then last 2 nights I'm doing 10-14.2 no EPR per lankylefty, maybe I should ask for a Bipap at some point, my flow rate seems almost totally irregular, every night despite AHIs under 5, sigh